目的 设计个性化喙锁韧带重建导向器，并评价其钻孔精度和效率。 方法 使用计算机辅助设计软件设计个性化喙锁韧带重建导向器，并进行3D打印。获取90侧肩关节标本，随机平均分为3组，分别在微创双切口下使用徒手法和C臂导向器、个性化导向器引导法进行锁骨-喙突钻孔。测量手术时间、喙突骨隧道分区和喙突骨隧道至喙突内、外侧缘距离。 结果 徒手组、C臂导向器组、个性化导向器组的手术时间分别为(203±33)、(267±62)、(155±14) s。3组分别有13、28、30个喙突骨隧道位于理想中间区。使用3种方法建立的喙突骨隧道与喙突内、外侧缘距离差分别为(3.7±2.0)、(2.0±0.9)、(0.9±0.5) mm。差异均有统计学意义(P<0.05)。 结论 个性化导向器具有更高的钻孔精度和效率，为微创下辅助锁骨-喙突钻孔提供了新的选择。
Abstract
Objective To design a personalized guide device for coracoclavicular ligament reconstruction and to evaluate its drilling accuracy and efficiency. Methods A personalized guide device for coracoclavicular ligament reconstruction was designed by using computer-aided design software and 3D printing. Ninety human shoulder specimens were obtained and randomly assigned into free-hand, C-ring and personalized groups for transclavicular-transcoracoid drilling with minimally invasive incisions. The surgical duration, the tunnel location zones and distances from the tunnel edge to the coracoid’s medial and lateral edges were measured. Results The surgical duration in the freehand group, the C-ring group and the personalized group were (203±33) s, (267±62) s, and (155±14) s, respectively. There were 13, 28 and 30 coracoid tunnels of the three groups located in the ideal middle zone, respectively. The absolute differences between distances from the tunnel edge to the coracoid’s medial and lateral edges in the three groups were (3.7±2.0) mm, (2.0±0.9) mm, and (0.9±0.5) mm, respectively. The differences were all statistically significant. Conclusion The personalized guide device achieved higher drilling accuracy and efficiency, which is a new choice for transclavicular-transcoracoid drilling in coracoclavicular ligament reconstruction with minimally invasive incisions.
关键词
肩锁关节脱位 /
喙锁韧带重建术 /
钻孔导向器 /
计算机辅助设计 /
3D打印
Key words
Acromioclavicular joint dislocation /
Coracoclavicular ligament reconstruction /
Guide device /
Computer aided design /
3D printing
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基金
国家自然科学基金（31771330），国家重点研发计划（2017YFC0110602），广东省科技计划项目（2015B010125006，2015B010125005），广州市科技计划项目（201704020129，201704020069）
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